Doctors want to offer lifesaving service. Patients are sent elsewhere

Three specialists want to provide Canberrans with a lifesaving and time critical stroke service, but health has instead organised to send patients to Sydney.

They want to offer endovascular clot retrieval at all hours in Canberra - one of the biggest developments in stroke treatment in the past 20 years.

It's a time-critical treatment and can greatly improve acute stroke patients' chance of survival and recovery.

But internal emails obtained by The Canberra Times through freedom of information laws show specialists are frustrated by the failure of Canberra Hospital to set up an out of hours service.

At present, it is only available during business hours at Canberra Hospital, with pathways recently introduced to send patients to Sydney out of hours.

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There are now three qualified specialists able to perform the clot retrieval in Canberra and they believe this is enough to run a 24-hour service immediately.

A Canberra Health Services spokeswoman on Friday said the hospital was working towards to having a 24-hour service running sometime this year.

The Australian Medical Association said the doctors should be able to perform the service in Canberra.

"I have incredibly high regard for the people involved in neurology both at Canberra and Calvary hospitals," ACT president Antonio Di Dio said.

"The services in terms of acute stroke that have been developed have been done with very good will and a lot of skill.

"It would be a shame if we could not use those skills more in Canberra and have fewer referrals to Sydney."

The emails obtained by The Canberra Times said the qualified doctors had at times performed the procedure out of hours, when they were not supposed to be working, out of a moral and ethical obligation.

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Neurosurgeon Dr Peter Mews - who is certified to perform the clot retrieval - said late last year in an email the plan to organise transfers to a Sydney hospital, instead of discussing out of hours services in Canberra was "deeply flawed".

"Whilst I am passionate about ECR ... and argue that [Canberra Hospital] needed to offer this service 'yesterday', ACT Health has steadfastly refused to engage myself or Dr Lalloo with regards to recognising our essential contribution to this service and discussing appropriate compensation for the onerous burden that provision of this service places on our time and lives," he said.

Another specialist able to perform clot retrieval, Dr Shivendra Lalloo, said in an email ACT Health had been spared public backlash by doctors performing the procedure out of hours.

"I suspect up to a third of clot retrievals have been performed out of hours, not resourced (therefore different legal implications both public and practitioner), and often the result of the consequence of the [doctor] feeling a sense of moral/ethical obligation under duress, given it is the standard of care," he said in an email in September last year.

"It is disappointing that we have to consider interim solutions over a fully resourced 24/7 service," he said in an email to clinicians and executives in October.

Dr Lalloo said a model where patients were sent to Sydney after hours would be tantamount to Canberra Hospital being downgraded.

The emails detailed an incident in October when a patient was transferred to Liverpool but faced significant delays.

A NSW Health employee encouraged the matter be submitted as an incident to "highlight the delays in treatment putting the patient at risk".

The emails said a NSW hospital had on many occasions offered to rotate one of their clot retrieval teams in Canberra.

"But this has not been accepted. However the offer remains open," the email said.

A Canberra Health Services spokeswoman said the plan was to have the 24-hour service running later this year.

"Planning processes are currently underway with clinicians to further develop the service to a 24-hour service," she said.

"This will require additional staffing in some clinical areas to ensure 24-hour rosters can be established for the ECR service.

"In order to maintain a sustainable service after hours and in periods of planned leave, we continue to have an interstate partnership in place."

She said a workshop was planned for May 12 with clinicians to further progress planning of the 24 hour service.